Successful management of long-term venovenous ECMO for severe PARDS in a child with acute lymphoblastic leukemia

Pediatric acute respiratory distress syndrome (PARDS) is an important cause of morbidity and mortality in pediatric intensive care units. We report successful prolonged venovenous extracorporeal membrane oxygenation (VV-ECMO) support in a child with severe PARDS and acute lymphoblastic leukemia (ALL). A 5-year-old boy with low-risk B-cell ALL developed severe refractory PARDS during induction therapy. VV-ECMO was initiated for profound hypoxemia and continued for 34 days, after which he was successfully decannulated. He was discharged after 235 days of hospitalization. This case suggests that prolonged VV-ECMO may be a feasible rescue strategy in carefully selected children with ALL when respiratory failure is potentially reversible and the oncological prognosis is favorable.